Hawaii 2022 Regular Session

Hawaii House Bill HB1679 Compare Versions

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1-HOUSE OF REPRESENTATIVES H.B. NO. 1679 THIRTY-FIRST LEGISLATURE, 2022 H.D. 2 STATE OF HAWAII A BILL FOR AN ACT RELATING TO ACUPUNCTURE. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
1+HOUSE OF REPRESENTATIVES H.B. NO. 1679 THIRTY-FIRST LEGISLATURE, 2022 H.D. 1 STATE OF HAWAII A BILL FOR AN ACT RELATING TO ACUPUNCTURE. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
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47- SECTION 1. The legislature finds that the regulation of medical professionals is important to ensure public safety and promote access to quality care. Acupuncture is one of the fastest growing fields in American health care due to expanded benefits under health insurance policies and medicare and is a popular treatment among patients seeking an alternative to prescription opioids and those with other medical conditions. The legislature further finds that a number of state laws regarding acupuncturists have not been updated in over twenty years, despite the growing demand for acupuncturists, changes to standards for national certifications, and expanded accredited educational programs, which now include master's and doctoral level degrees. Accordingly, the purpose of this Act is to make comprehensive updates to chapter 436E, Hawaii Revised Statutes, regarding acupuncture practitioners to reflect modernized scopes of practice and licensing requirements. SECTION 2. Chapter 436E, Hawaii Revised Statutes, is amended by adding three new sections to be appropriately designated and to read as follows: "§436E-A Requirements for initial licensure. (a) To qualify for licensure after July 1, 2023, an applicant shall submit evidence satisfactory to the board that the applicant meets the following educational and examination requirements: (1) An individual applying for initial licensure shall have successfully completed an acupuncture medicine program from an accredited acupuncture medicine institution; provided that those applicants who graduated with an earned master's degree may apply to the board for the "L.Ac." license designation, and those applicants who graduated with an earned doctorate degree may apply to the board for the "D.Ac." license designation; and (2) All applicants for initial licensure shall pass examinations and be certified by the National Certification Commission for Acupuncture and Oriental Medicine, or its successor entity. (b) Applicants who have earned a bachelor's, master's, or doctoral degree from a foreign university or college shall demonstrate curricula and standards equivalent to or higher than accredited institutions in the United States, which have been recognized and approved by the board. The board may contract with a third-party agency to determine equivalency, at cost to the applicant. §436E-B Legacy exemptions. Any current acupuncture licensees in the State as of July 1, 2023, shall be designated legacy status by the board for their current license designation, allowing for the practice of acupuncture medicine. If a license that was issued before July 1, 2023, lapses and is not restored within two years of its expiration date, the licensee shall be subject to the licensure requirements pursuant to section 436E-A. §436E-C Reciprocity. (a) The board may issue a license by reciprocity to an acupuncturist if the applicant: (1) Files an application and pays fees as prescribed by the board; (2) Holds a current, unencumbered, active license in another state or territory that requires qualifications equivalent to or greater than the qualifications for licensure in the State as specified in section 436E-A; and (3) Holds a current certification with the National Certification Commission for Acupuncture and Oriental Medicine, or its successor entity. (b) For applicants who graduated before September 1, 2000, the board may issue a license by reciprocity to an acupuncturist if the applicant: (1) Files an application and pays fees as prescribed by the board; (2) Holds a current, unencumbered, active license in another state or territory; and (3) Holds a current certification with the National Certification Commission for Acupuncture and Oriental Medicine, or its successor entity." SECTION 3. Section 436E-1, Hawaii Revised Statutes, is amended to read as follows: "[[]§436E-1[]] Declaration of necessity for regulation and control. The legislature hereby finds and declares that acupuncture medicine is an evidence-based medicine rooted in traditional and modern modalities and that the practice of acupuncture [is a theory and method for] medicine includes examination, evaluation, diagnosis, and treatment of [illness and disability and for strengthening and invigorating the body and as such affects] the patient, therefore requiring regulation and control for public health, safety, and welfare[, and therefore there is a necessity that individuals practicing acupuncture be subject to regulation and control]." SECTION 4. Section 436E-2, Hawaii Revised Statutes, is amended as follows: 1. By adding seven new definitions to be appropriately inserted and to read: ""Accredited acupuncture medicine institution" means a school or college accredited or recognized as a candidate for accreditation by an acupuncture medicine accrediting body recognized by the United States Department of Education. "Acupuncture medicine" means the evidence-based medicine rooted in traditional theories and practices, integrated with modern biomedical theories and practices. "Acupuncture medicine doctor" means an acupuncture practitioner engaged in the practice of advanced acupuncture medicine. "Licensed acupuncturist" means an acupuncture practitioner who has complied with all educational and professional examination requirements as determined by the board and whose license remains in good standing with the board, utilizing the license designation "L.Ac.". "Licensed doctor of acupuncture" means an acupuncture medicine doctor who has complied with all educational and professional examination requirements as determined by the board and whose license remains in good standing with the board, utilizing the license designation "D.Ac.". "Practice of acupuncture medicine" means the practice of acupuncture with adjunctive therapies, including but not limited to manual, mechanical, electrical, light, sound, electromagnetic, thermal therapy, herbal and nutraceutical medicines, lifestyle and nutritional counseling, movement, and other traditional and modern techniques as further determined by rules adopted by the board. "Practice of advanced acupuncture medicine" means the practice of acupuncture medicine and the use of advanced diagnostics, specialties, and therapeutics, as further determined by rules adopted by the board." 2. By amending the definition of "acupuncture practitioner" to read: ""Acupuncture practitioner" means a person engaged in the practice of acupuncture[.] medicine." 3. By amending the definition of "practice of acupuncture" to read: ""Practice of acupuncture" means [stimulation of a certain acupuncture point or points on the human body for the purpose of controlling and regulating the flow and balance of energy in the body. The practice includes the techniques of piercing] the integrative examination, evaluation, diagnosis, prevention, and treatment of a physical, mental, or emotional disease in the patient by stimulating tissue by puncturing the skin [by inserting needles and point stimulation by the use of acupressure, electrical, mechanical, thermal, or traditional therapeutic means.] with a needle approved by the United States Food and Drug Administration to various depths or utilizing other means to achieve a response." SECTION 5. Section 436E-3, Hawaii Revised Statutes, is amended to read as follows: "§436E-3 [License required.] Licensure. Except as otherwise provided by law, no person shall engage in the practice of acupuncture, practice of acupuncture medicine, or practice of advanced acupuncture medicine or use the title "acupuncturist" in [this] the State, either gratuitously or for pay, [or shall offer to so practice, or shall announce themselves either publicly or privately as prepared or qualified to so practice any method of acupuncture] without having [a valid unrevoked license or] an acupuncture medicine intern permit [from the State; provided that the requirement for a permit shall not be enforced until the board has initially adopted rules] pursuant to section 436E-3.6[.] or an "L.Ac." or "D.Ac." license designation from the board." SECTION 6. Section 436E-3.5, Hawaii Revised Statutes, is amended to read as follows: "§436E-3.5 Physicians and osteopaths not exempt. Persons licensed under chapter 453 who desire to engage in the practice of acupuncture, practice of acupuncture medicine, or practice of advanced acupuncture medicine shall be subject to licensing under this chapter." SECTION 7. Section 436E-3.6, Hawaii Revised Statutes, is amended to read as follows: "[[]§436E-3.6[]] Acupuncture medicine intern permit required. [(a) Except as otherwise provided by law, no] No person shall engage in the practice [as an] of acupuncture, practice of acupuncture medicine, or practice of advanced acupuncture medicine as an intern in [this] the State, either gratuitously or for pay, [without having first obtained a permit from the board. This permit shall entitle the applicant to engage in the practice of acupuncture for a period of four years under the immediate supervision of a licensed acupuncturist duly licensed under this chapter. (b) An acupuncture intern permit may be reissued once, for a period not to exceed one year, upon written request to the board and payment of the required fee. (c) The board shall adopt rules pursuant to chapter 91 defining the functions of an acupuncture intern, establishing the requirements to be met by an applicant for an acupuncture intern permit, and specifying the procedures for the immediate supervision of the acupuncture intern by a licensed acupuncturist.] unless the intern: (1) Is actively enrolled in a program with an accredited acupuncture medicine institution; (2) Has obtained a permit from the board, which shall be valid for four years and may be renewed once for a period not to exceed one year; and (3) Is practicing under the immediate supervision of an acupuncture practitioner or acupuncture medicine doctor who is licensed in the State and contracted or employed through an accredited acupuncture medicine institution." SECTION 8. Section 436E-6, Hawaii Revised Statutes, is amended to read as follows: "§436E-6 Board of acupuncture. (a) There shall be a board of acupuncture, the members of which shall be appointed by the governor. The board shall consist of five persons, two of whom shall be private citizens and three shall be [acupuncturists licensed in accordance with this chapter.] licensed acupuncturists or licensed doctors of acupuncture. (b) [Commencing July 1, 1992, and thereafter, each] Each person appointed to the board shall have a four-year term and shall serve [not] no more than two consecutive terms. [Members appointed to the board prior to July 1, 1992, shall be permitted to continue to serve on the board until such time when a maximum of eight consecutive years from the date of initial appointment has been attained.]" SECTION 9. Section 436E-7, Hawaii Revised Statutes, is amended to read as follows: "§436E-7 Powers and duties of the board. In addition to any other powers and duties authorized by law, the board shall: (1) Adopt rules in accordance with chapter 91 to carry out the purposes of this chapter, with special emphasis on the health and safety of the public; (2) [Develop] Define and clarify ongoing standards for licensure; (3) Define and clarify standards and practices for license renewal, including continuing education requirements; [(3)] (4) Prepare, administer, and grade examinations, provided that the board may contract with a testing agency to provide those services; [(4)] (5) Issue, renew, suspend, and revoke licenses; [(5)] (6) Register applicants or holders of a license; [(6)] (7) Investigate and conduct hearings regarding any violation of this chapter and any rules of the board; [(7)] (8) Maintain a record of its proceedings; [and] (9) Define and clarify reciprocity for persons licensed in other jurisdictions visiting the State for purposes of education and instruction, within a limited scope of time; (10) Define and clarify standards for reciprocity for persons licensed in other jurisdictions who have: (A) Completed their education prior to the year 2000; (B) Maintained their license; and (C) Maintained their certification with the National Certification Commission for Acupuncture and Oriental Medicine; and [(8)] (11) Do all things necessary to carry out the functions, powers, and duties set forth in the chapter." SECTION 10. Section 436E-9, Hawaii Revised Statutes, is amended to read as follows: "[[]§436E-9[]] Biennial renewal[.]; continuing education. (a) Every person holding a license under this chapter shall register with the board and pay a biennial fee on or before June 30 of each odd-numbered year. Failure to pay the biennial fee shall constitute a forfeiture of the license as of the date of expiration. Any license so forfeited may be restored within [one year] two years after the expiration upon filing of an application and payment of a restoration fee. (b) Beginning with the renewal for the licensing biennium commencing July 1, 2025, and every biennial renewal thereafter, all licensees in the State shall be in compliance with continuing education requirements, as approved by the board, by obtaining at least thirty credit hours, which shall include at least two credit hours of ethics and at least two credit hours of safety. The board shall adopt rules pursuant to chapter 91 relating to the requirements and standards that continuing education programs shall meet to obtain recognition and approval from the board. (c) To determine compliance with the continuing education requirement under subsection (b), the board may conduct a random audit of licensees. A licensee selected for audit shall be notified by the board. Within sixty days of notification, the licensee shall provide the board documentation to verify compliance with the continuing education requirements. (d) Licensees shall hold a current and valid cardiopulmonary resuscitation certification." SECTION 11. Section 436E-10, Hawaii Revised Statutes, is amended to read as follows: "§436E-10 Revocation or suspension of licenses[.]; penalties. (a) In addition to any other actions authorized by law, any license to engage in the practice of acupuncture, practice of acupuncture medicine, or practice of advanced acupuncture medicine under this chapter may be revoked or suspended by the board of acupuncture at any time in a proceeding before the board for any cause authorized by law, including but not limited to the following: (1) Obtaining a fee on the assurance that a manifestly incurable ailment can be permanently cured; (2) The use of false, fraudulent, or deceptive advertising and making untruthful and improbable statements; (3) [Habitually using] Using any [habit-forming] intoxicant or controlled substance[, such as opium or any of its derivatives, morphine, heroin, or cocaine;] that impairs or compromises a licensee's duties, as determined by rules; (4) Procuring a license through fraud, misrepresentation, or deceit; (5) Professional misconduct [or], gross carelessness, ethics violations, or manifest incapacity [in the practice of acupuncture;], as determined by rules; or (6) Violating any rules adopted under this chapter. (b) Any person except a person licensed under this chapter who practices, treats, or instructs in any phase of acupuncture or acupuncture medicine without a license or permit issued by the board, or uses any word or title to induce the belief that the person is engaged in the practice of any type of acupuncture or acupuncture medicine, shall be guilty of a misdemeanor and subject to a fine of no less than $1,000 for each day of violation. The department may also seek all legal and equitable remedies available to it for the enforcement of the provisions of this chapter, including injunctive relief." SECTION 12. Section 436E-4, Hawaii Revised Statutes, is repealed. ["§436E-4 Exemptions. A licensed acupuncturist of another state or country for demonstrations or lectures to be given at acupuncture or medical society meetings or at acupuncture schools shall be exempt from licensing procedures set forth in this chapter."] SECTION 13. Section 436E-5, Hawaii Revised Statutes, is repealed. ["§436E-5 Qualifications for examination. (a) No person shall be licensed to practice acupuncture unless the person has passed an examination and has been found to have the necessary qualifications as prescribed in the rules adopted by the board pursuant to chapter 91. (b) Prior to September 1, 2000, and except as provided in subsection (c), before any applicant shall be eligible for the examination, the applicant shall furnish satisfactory proof to the board that the applicant has received a total of not less than one thousand five hundred hours of education and training consisting of: (1) A formal program in the science of acupuncture (traditional oriental medicine) at an institute or school approved by the board that: (A) Shall be for a period of not less than two academic years (not less than six hundred hours); and (B) Shall result in the award of a certificate or diploma; and (2) One clinical year in a clinical internship program (not less than twelve months and not less than nine hundred hours) supervised by a licensed acupuncturist; provided that the nine hundred hours of the clinical internship program may be obtained from the institute or school awarding the certificate or diploma or may be obtained under the supervision of a licensed acupuncturist not affiliated with an institute or school. (c) Students who started training prior to December 31, 1984, in a school approved by the board prior to December 31, 1984, and who complete their training by December 31, 1989, and who file an application with the board before September 1, 2000 shall: (1) Not lose their rights of continued education, and earned or accumulated credits; and (2) For the purposes of this chapter, meet requirements for examination and licensure as provided in chapter 436D and rules adopted by the board as they existed on December 31, 1984; provided that the school has not altered its program so as to lower the standards for completion of the program. These students may qualify for examination if they submit evidence of having completed: (A) At least eighteen months (not less than five hundred seventy-six hours) of academic training; and (B) At least six months (not less than four hundred eighty hours) of clinical training in the practice of acupuncture on human subjects under the supervision of a licensed acupuncturist. (d) Notwithstanding subsections (b) and (c), effective September 1, 2000, before any applicant shall be eligible to take the licensing examination, the applicant shall furnish satisfactory proof to the board that the applicant has completed a formal acupuncture program and has received a total of at least two thousand, one hundred seventy-five hours of academic and clinical training consisting of an academic program of at least one thousand, five hundred fifteen hours in the science of acupuncture (traditional oriental medicine) and a clinical training program of at least six hundred sixty hours under the supervision of a licensed acupuncturist, which shall result in the award of a certificate or diploma. For applicants who graduated from an institute, school, or college located in the United States or any territory under the jurisdiction of the United States, the institute, school, or college shall be accredited or recognized as a candidate for accreditation by any acupuncture or oriental medicine accrediting body recognized by the United States Department of Education. For applicants who graduated from a foreign institute, school, or college with a formal program in the science of acupuncture, the applicant, at the applicant's own expense, shall have the applicant's transcripts and curriculum evaluated by a board approved and designated professional evaluator who shall make a determination whether the transcripts and curriculum are at least equivalent to that of the United States accredited acupuncture program, and that the foreign institute is licensed, approved, or accredited by the appropriate governmental authority or an agency recognized by a governmental authority in the respective foreign jurisdiction and whose curriculum is approved by the board."] SECTION 14. Section 436E-12, Hawaii Revised Statutes, is repealed. ["[§436E-12] Penalty. (a) Any person except a person licensed under this chapter who practices, treats, or instructs in any phase of acupuncture without a license or permit issued by the board, or uses any word or title to induce the belief that they are engaged in the practice of any type of acupuncture, shall be guilty of a misdemeanor and subject to a fine of not less than $50 nor more than $1,000 for each violation. (b) Any person, except a licensed acupuncturist, who: (1) Practices or attempts to practice acupuncture; (2) Buys, sells, or fraudulently obtains any diploma or license to practice acupuncture whether recorded or not; (3) Uses the title "acupuncturist", "D.Ac." or "D.O.M." or any word or title to induce the belief that the person is engaged in the practice of acupuncture without complying with this chapter; or (4) Violates this chapter; shall be penalized as provided in subsection (a). The department may also seek all legal and equitable remedies available to it for the enforcement of the provisions of this chapter, including seeking injunctive relief."] SECTION 15. Section 436E-13, Hawaii Revised Statutes, is repealed. ["§436E-13 Use of titles. (a) A licensee who has been awarded a license to practice acupuncture by the board in this State may use the title of "Licensed Acupuncturist" or designation "L.Ac." with the licensee's name in an advertisement for acupuncture or announce or append the designation to the licensee's name. (b) A licensee who has been awarded an earned doctoral degree may use the designation "Ph.D." in an advertisement for acupuncture or announce or append the designation to the licensee's name if the degree was granted from a university or college recognized by a regional or national accrediting body recognized by the United States Department of Education. A Ph.D. recognized by the board under this subsection shall designate a nonpractitioner as opposed to a practitioner or "doctor" of acupuncture as provided in subsection (c). (c) A licensee who has been approved by the board to use the doctor of acupuncture title, may use the title "Doctor of Acupuncture" or designation of "D.Ac.", after the licensee's name, or the term "Doctor" or prefix "Dr." provided that the word "Acupuncturist" immediately follows the licensee's name if the term "Doctor", or the prefix "Dr." is used alone. (d) Before any licensee shall be eligible to use the doctor of acupuncture title, the licensee shall furnish satisfactory proof to the board that the licensee has been awarded an earned doctoral degree in acupuncture (traditional oriental medicine). For licensees who graduated from an institute, school, or college located in the United States or any territory under the jurisdiction of the United States, the institute, school, or college shall be accredited or recognized as a candidate for accreditation by a regional or national accrediting body that is recognized by the United States Department of Education for the accreditation or pre‑accreditation ("candidacy") of professional post-graduate doctoral programs in acupuncture and oriental medicine. For licensees who graduated from a foreign institute, school, or college, the licensee, at the licensee's own expense, shall have the licensee's transcripts and curriculum evaluated by a board approved and designated professional evaluator who shall make a determination on whether the transcripts and curriculum are at least equivalent to the United States recognized doctoral program of study in acupuncture and oriental medicine, and that the foreign institute is licensed, approved, or accredited by the appropriate governmental authority or an agency recognized by a governmental authority in the respective foreign jurisdiction and whose curriculum is approved by the board. (e) Except as provided in this section, use of other titles, prefixes, or designations shall not be permitted."] SECTION 16. Section 436E-14, Hawaii Revised Statutes, is repealed. ["[§436E-14] Foreign school curricula and standards. The board of acupuncture shall not recognize and approve an earned doctoral degree from a foreign university or college whose curricula and standards are not equivalent to or higher than institutions in the United States which have been recognized and approved by the board in the study or practice of acupuncture."] SECTION 17. In codifying the new sections added by section 2 of this Act, the revisor of statutes shall substitute appropriate section numbers for the letters used in designating the new sections in this Act. SECTION 18. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored. SECTION 19. This Act shall take effect on July 1, 2060.
47+ SECTION 1. The legislature finds that the regulation of medical professionals is important to ensure public safety and promote access to quality care. Acupuncture is one of the fastest growing fields in American health care due to expanded benefits under health insurance policies and medicare and is a popular treatment among patients seeking an alternative to prescription opioids and those with other medical conditions. The legislature further finds that a number of state laws regarding acupuncturists have not been updated in over twenty years, despite the growing demand for acupuncturists, changes to standards for national certifications, and expanded accredited educational programs, which now include master's and doctoral level degrees. Accordingly, the purpose of this Act is to make comprehensive updates to chapter 436E, Hawaii Revised Statutes, regarding acupuncture practitioners to reflect modernized scopes of practice and licensing requirements. SECTION 2. Chapter 436E, Hawaii Revised Statutes, is amended by adding two new sections to be appropriately designated and to read as follows: "§436E-A Requirements for initial licensure. (a) To qualify for licensure after July 1, 2023, an applicant shall submit evidence satisfactory to the board that the applicant meets the following educational and examination requirements: (1) An individual applying for initial licensure shall have successfully completed an acupuncture medicine program from an accredited acupuncture medicine institution; provided that those applicants who graduated with an earned master's degree may apply to the board for the "L.Ac." license designation, and those applicants who graduated with an earned doctorate degree may apply to the board for the "D.Ac." license designation; and (2) All applicants for initial licensure shall pass examinations and be certified by the National Certification Commission for Acupuncture and Oriental Medicine, or its successor entity. (b) Applicants who have earned a bachelor's, master's, or doctoral degree from a foreign university or college shall demonstrate curricula and standards equivalent to or higher than accredited institutions in the United States, which have been recognized and approved by the board. The board may contract with a third-party agency to determine equivalency, at cost to the applicant. §436E-B Legacy exemptions. Any current acupuncture licensees in the State as of July 1, 2023, shall be designated legacy status by the board for their current license designation, allowing for the practice of acupuncture medicine. If a license that was issued before July 1, 2023, lapses and is not restored within two years of its expiration date, the licensee shall be subject to the licensure requirements pursuant to section 436E-A." SECTION 3. Section 436E-1, Hawaii Revised Statutes, is amended to read as follows: "[[]§436E-1[]] Declaration of necessity for regulation and control. The legislature hereby finds and declares that acupuncture medicine is an evidence-based medicine rooted in traditional and modern modalities and that the practice of acupuncture [is a theory and method for] medicine includes examination, evaluation, diagnosis, and treatment of [illness and disability and for strengthening and invigorating the body and as such affects] the patient, therefore requiring regulation and control for public health, safety, and welfare[, and therefore there is a necessity that individuals practicing acupuncture be subject to regulation and control]." SECTION 4. Section 436E-2, Hawaii Revised Statutes, is amended as follows: 1. By adding seven new definitions to be appropriately inserted and to read: ""Accredited acupuncture medicine institution" means a school or college accredited or recognized as a candidate for accreditation by an acupuncture medicine accrediting body recognized by the United States Department of Education. "Acupuncture medicine" means the evidence-based medicine rooted in traditional theories and practices, integrated with modern biomedical theories and practices. "Acupuncture medicine doctor" means an acupuncture practitioner engaged in the practice of advanced acupuncture medicine. "Licensed acupuncturist" is an acupuncture practitioner who has complied with all educational and professional examination requirements as determined by the board and whose license remains in good standing with the board, utilizing the license designation "L.Ac.". "Licensed doctor of acupuncture" is an acupuncture medicine doctor who has complied with all educational and professional examination requirements as determined by the board and whose license remains in good standing with the board, utilizing the license designation "D.Ac.". "Practice of acupuncture medicine" means the practice of acupuncture with adjunctive therapies, including but not limited to manual, mechanical, electrical, light, sound, electromagnetic, thermal therapy, herbal and nutraceutical medicines, lifestyle and nutritional counseling, movement, and other traditional and modern techniques as further determined by rules adopted by the board. "Practice of advanced acupuncture medicine" means the practice of acupuncture medicine and the use of advanced diagnostics, specialties, and therapeutics, based on additional traditional and biomedical internal medicine training, as further determined by rules adopted by the board." 2. By amending the definition of "acupuncture practitioner" to read: ""Acupuncture practitioner" means a person engaged in the practice of acupuncture[.] medicine." 3. By amending the definition of "practice of acupuncture" to read: ""Practice of acupuncture" means [stimulation of a certain acupuncture point or points on the human body for the purpose of controlling and regulating the flow and balance of energy in the body. The practice includes the techniques of piercing] the integrative examination, evaluation, diagnosis, prevention, and treatment of a physical, mental, or emotional disease in the patient by stimulating tissue by puncturing the skin [by inserting needles and point stimulation by the use of acupressure, electrical, mechanical, thermal, or traditional therapeutic means.] with a needle approved by the United States Food and Drug Administration to various depths or utilizing other means to achieve a response." SECTION 5. Section 436E-3, Hawaii Revised Statutes, is amended to read as follows: "§436E-3 [License required.] Licensure. Except as otherwise provided by law, no person shall practice acupuncture or acupuncture medicine or use the title "acupuncturist" in this State, either gratuitously or for pay, [or shall offer to so practice, or shall announce themselves either publicly or privately as prepared or qualified to so practice any method of acupuncture] without having [a valid unrevoked license or] first obtained an acupuncture medicine intern permit [from the State; provided that the requirement for a permit shall not be enforced until the board has initially adopted rules] pursuant to section 436E-3.6[.] or an "L.Ac." or "D.Ac." license designation from the board." SECTION 6. Section 436E-3.5, Hawaii Revised Statutes, is amended to read as follows: "§436E-3.5 Physicians and osteopaths not exempt. Persons licensed under chapter 453 who desire to practice acupuncture or acupuncture medicine shall be subject to licensing under this chapter." SECTION 7. Section 436E-3.6, Hawaii Revised Statutes, is amended to read as follows: "[[]§436E-3.6[]] Acupuncture medicine intern permit required. [(a) Except as otherwise provided by law, no] No person shall practice [as an] acupuncture or acupuncture medicine as an intern in this State, either gratuitously or for pay, [without having first obtained a permit from the board. This permit shall entitle the applicant to engage in the practice of acupuncture for a period of four years under the immediate supervision of a licensed acupuncturist duly licensed under this chapter. (b) An acupuncture intern permit may be reissued once, for a period not to exceed one year, upon written request to the board and payment of the required fee. (c) The board shall adopt rules pursuant to chapter 91 defining the functions of an acupuncture intern, establishing the requirements to be met by an applicant for an acupuncture intern permit, and specifying the procedures for the immediate supervision of the acupuncture intern by a licensed acupuncturist.] unless the intern: (1) Is actively enrolled in a program with an accredited acupuncture medicine institution; (2) Has obtained a permit from the board, which shall be valid for four years and may be renewed once for a period not to exceed one year; and (3) Is practicing under the immediate supervision of an acupuncture practitioner or acupuncture medicine doctor who is licensed in the State and contracted or employed through an accredited acupuncture medicine institution." SECTION 8. Section 436E-6, Hawaii Revised Statutes, is amended to read as follows: "§436E-6 Board of acupuncture. (a) There shall be a board of acupuncture, the members of which shall be appointed by the governor. The board shall consist of five persons, two of whom shall be private citizens and three shall be [acupuncturists licensed in accordance with this chapter.] licensed acupuncturists or licensed doctors of acupuncture. (b) [Commencing July 1, 1992, and thereafter, each] Each person appointed to the board shall have a four-year term and shall serve not more than two consecutive terms. [Members appointed to the board prior to July 1, 1992, shall be permitted to continue to serve on the board until such time when a maximum of eight consecutive years from the date of initial appointment has been attained.]" SECTION 9. Section 436E-7, Hawaii Revised Statutes, is amended to read as follows: "§436E-7 Powers and duties of the board. In addition to any other powers and duties authorized by law, the board shall: (1) Adopt rules in accordance with chapter 91 to carry out the purposes of this chapter, with special emphasis on the health and safety of the public; (2) [Develop] Define and clarify ongoing standards for licensure; (3) Define and clarify standards and practices for license renewal, including continuing education requirements; [(3)] (4) Prepare, administer, and grade examinations, provided that the board may contract with a testing agency to provide those services; [(4)] (5) Issue, renew, suspend, and revoke licenses; [(5)] (6) Register applicants or holders of a license; [(6)] (7) Investigate and conduct hearings regarding any violation of this chapter and any rules of the board; [(7)] (8) Maintain a record of its proceedings; [and] (9) Define and clarify reciprocity for acupuncture licensees from other jurisdictions visiting the State for purposes of education and instruction, within a limited scope of time; (10) Define and clarify standards for reciprocity for licensees from other jurisdictions who have: (A) Completed their education prior to the year 2000; (B) Maintained their license; and (C) Maintained their certification with the National Certification Commission for Acupuncture and Oriental Medicine; and [(8)] (11) Do all things necessary to carry out the functions, powers, and duties set forth in the chapter." SECTION 10. Section 436E-9, Hawaii Revised Statutes, is amended to read as follows: "[[]§436E-9[]] Biennial renewal[.]; continuing education. (a) Every person holding a license under this chapter shall register with the board and pay a biennial fee on or before June 30 of each odd-numbered year. Failure to pay the biennial fee shall constitute a forfeiture of the license as of the date of expiration. Any license so forfeited may be restored within [one year] two years after the expiration upon filing of an application and payment of a restoration fee. (b) Beginning with the renewal for the licensing biennium commencing July 1, 2023, and every biennial renewal thereafter, all licensees in the State shall be in compliance with continuing acupuncture medicine education requirements, as approved by the board, by obtaining at least thirty credit hours of continuing education, which shall include at least two credit hours of ethics and at least two credit hours of safety. Licensees shall hold a current and valid cardiopulmonary resuscitation certification as a condition of license renewal." SECTION 11. Section 436E-10, Hawaii Revised Statutes, is amended to read as follows: "§436E-10 Revocation or suspension of licenses[.]; penalties. (a) In addition to any other actions authorized by law, any license to practice acupuncture or acupuncture medicine under this chapter may be revoked or suspended by the board of acupuncture at any time in a proceeding before the board for any cause authorized by law, including but not limited to the following: (1) Obtaining a fee on the assurance that a manifestly incurable ailment can be permanently cured; (2) The use of false, fraudulent, or deceptive advertising and making untruthful and improbable statements; (3) [Habitually using] Using any [habit-forming] intoxicant or controlled substance[, such as opium or any of its derivatives, morphine, heroin, or cocaine;] that impairs or compromises a licensee's duties, as determined by rules; (4) Procuring a license through fraud, misrepresentation, or deceit; (5) Professional misconduct [or], gross carelessness, ethics violations, or manifest incapacity [in the practice of acupuncture;], as determined by rules; or (6) Violating any rules adopted under this chapter. (b) Any person except a person licensed under this chapter who practices, treats, or instructs in any phase of acupuncture or acupuncture medicine without a license or permit issued by the board, or uses any word or title to induce the belief that the person is engaged in the practice of any type of acupuncture or acupuncture medicine, shall be guilty of a misdemeanor and subject to a fine of not less than $1,000 for each day of violation. The department may also seek all legal and equitable remedies available to it for the enforcement of the provisions of this chapter, including injunctive relief." SECTION 12. Section 436E-4, Hawaii Revised Statutes, is repealed. ["§436E-4 Exemptions. A licensed acupuncturist of another state or country for demonstrations or lectures to be given at acupuncture or medical society meetings or at acupuncture schools shall be exempt from licensing procedures set forth in this chapter."] SECTION 13. Section 436E-5, Hawaii Revised Statutes, is repealed. ["§436E-5 Qualifications for examination. (a) No person shall be licensed to practice acupuncture unless the person has passed an examination and has been found to have the necessary qualifications as prescribed in the rules adopted by the board pursuant to chapter 91. (b) Prior to September 1, 2000, and except as provided in subsection (c), before any applicant shall be eligible for the examination, the applicant shall furnish satisfactory proof to the board that the applicant has received a total of not less than one thousand five hundred hours of education and training consisting of: (1) A formal program in the science of acupuncture (traditional oriental medicine) at an institute or school approved by the board that: (A) Shall be for a period of not less than two academic years (not less than six hundred hours); and (B) Shall result in the award of a certificate or diploma; and (2) One clinical year in a clinical internship program (not less than twelve months and not less than nine hundred hours) supervised by a licensed acupuncturist; provided that the nine hundred hours of the clinical internship program may be obtained from the institute or school awarding the certificate or diploma or may be obtained under the supervision of a licensed acupuncturist not affiliated with an institute or school. (c) Students who started training prior to December 31, 1984, in a school approved by the board prior to December 31, 1984, and who complete their training by December 31, 1989, and who file an application with the board before September 1, 2000 shall: (1) Not lose their rights of continued education, and earned or accumulated credits; and (2) For the purposes of this chapter, meet requirements for examination and licensure as provided in chapter 436D and rules adopted by the board as they existed on December 31, 1984; provided that the school has not altered its program so as to lower the standards for completion of the program. These students may qualify for examination if they submit evidence of having completed: (A) At least eighteen months (not less than five hundred seventy-six hours) of academic training; and (B) At least six months (not less than four hundred eighty hours) of clinical training in the practice of acupuncture on human subjects under the supervision of a licensed acupuncturist. (d) Notwithstanding subsections (b) and (c), effective September 1, 2000, before any applicant shall be eligible to take the licensing examination, the applicant shall furnish satisfactory proof to the board that the applicant has completed a formal acupuncture program and has received a total of at least two thousand, one hundred seventy-five hours of academic and clinical training consisting of an academic program of at least one thousand, five hundred fifteen hours in the science of acupuncture (traditional oriental medicine) and a clinical training program of at least six hundred sixty hours under the supervision of a licensed acupuncturist, which shall result in the award of a certificate or diploma. For applicants who graduated from an institute, school, or college located in the United States or any territory under the jurisdiction of the United States, the institute, school, or college shall be accredited or recognized as a candidate for accreditation by any acupuncture or oriental medicine accrediting body recognized by the United States Department of Education. For applicants who graduated from a foreign institute, school, or college with a formal program in the science of acupuncture, the applicant, at the applicant's own expense, shall have the applicant's transcripts and curriculum evaluated by a board approved and designated professional evaluator who shall make a determination whether the transcripts and curriculum are at least equivalent to that of the United States accredited acupuncture program, and that the foreign institute is licensed, approved, or accredited by the appropriate governmental authority or an agency recognized by a governmental authority in the respective foreign jurisdiction and whose curriculum is approved by the board."] SECTION 14. Section 436E-12, Hawaii Revised Statutes, is repealed. ["[§436E-12] Penalty. (a) Any person except a person licensed under this chapter who practices, treats, or instructs in any phase of acupuncture without a license or permit issued by the board, or uses any word or title to induce the belief that they are engaged in the practice of any type of acupuncture, shall be guilty of a misdemeanor and subject to a fine of not less than $50 nor more than $1,000 for each violation. (b) Any person, except a licensed acupuncturist, who: (1) Practices or attempts to practice acupuncture; (2) Buys, sells, or fraudulently obtains any diploma or license to practice acupuncture whether recorded or not; (3) Uses the title "acupuncturist", "D.Ac." or "D.O.M." or any word or title to induce the belief that the person is engaged in the practice of acupuncture without complying with this chapter; or (4) Violates this chapter; shall be penalized as provided in subsection (a). The department may also seek all legal and equitable remedies available to it for the enforcement of the provisions of this chapter, including seeking injunctive relief."] SECTION 15. Section 436E-13, Hawaii Revised Statutes, is repealed. ["§436E-13 Use of titles. (a) A licensee who has been awarded a license to practice acupuncture by the board in this State may use the title of "Licensed Acupuncturist" or designation "L.Ac." with the licensee's name in an advertisement for acupuncture or announce or append the designation to the licensee's name. (b) A licensee who has been awarded an earned doctoral degree may use the designation "Ph.D." in an advertisement for acupuncture or announce or append the designation to the licensee's name if the degree was granted from a university or college recognized by a regional or national accrediting body recognized by the United States Department of Education. A Ph.D. recognized by the board under this subsection shall designate a nonpractitioner as opposed to a practitioner or "doctor" of acupuncture as provided in subsection (c). (c) A licensee who has been approved by the board to use the doctor of acupuncture title, may use the title "Doctor of Acupuncture" or designation of "D.Ac.", after the licensee's name, or the term "Doctor" or prefix "Dr." provided that the word "Acupuncturist" immediately follows the licensee's name if the term "Doctor", or the prefix "Dr." is used alone. (d) Before any licensee shall be eligible to use the doctor of acupuncture title, the licensee shall furnish satisfactory proof to the board that the licensee has been awarded an earned doctoral degree in acupuncture (traditional oriental medicine). For licensees who graduated from an institute, school, or college located in the United States or any territory under the jurisdiction of the United States, the institute, school, or college shall be accredited or recognized as a candidate for accreditation by a regional or national accrediting body that is recognized by the United States Department of Education for the accreditation or pre‑accreditation ("candidacy") of professional post-graduate doctoral programs in acupuncture and oriental medicine. For licensees who graduated from a foreign institute, school, or college, the licensee, at the licensee's own expense, shall have the licensee's transcripts and curriculum evaluated by a board approved and designated professional evaluator who shall make a determination on whether the transcripts and curriculum are at least equivalent to the United States recognized doctoral program of study in acupuncture and oriental medicine, and that the foreign institute is licensed, approved, or accredited by the appropriate governmental authority or an agency recognized by a governmental authority in the respective foreign jurisdiction and whose curriculum is approved by the board. (e) Except as provided in this section, use of other titles, prefixes, or designations shall not be permitted."] SECTION 16. Section 436E-14, Hawaii Revised Statutes, is repealed. ["[§436E-14] Foreign school curricula and standards. The board of acupuncture shall not recognize and approve an earned doctoral degree from a foreign university or college whose curricula and standards are not equivalent to or higher than institutions in the United States which have been recognized and approved by the board in the study or practice of acupuncture."] SECTION 17. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored. SECTION 18. This Act shall take effect on July 1, 2060.
4848
4949 SECTION 1. The legislature finds that the regulation of medical professionals is important to ensure public safety and promote access to quality care. Acupuncture is one of the fastest growing fields in American health care due to expanded benefits under health insurance policies and medicare and is a popular treatment among patients seeking an alternative to prescription opioids and those with other medical conditions. The legislature further finds that a number of state laws regarding acupuncturists have not been updated in over twenty years, despite the growing demand for acupuncturists, changes to standards for national certifications, and expanded accredited educational programs, which now include master's and doctoral level degrees.
5050
5151 Accordingly, the purpose of this Act is to make comprehensive updates to chapter 436E, Hawaii Revised Statutes, regarding acupuncture practitioners to reflect modernized scopes of practice and licensing requirements.
5252
53- SECTION 2. Chapter 436E, Hawaii Revised Statutes, is amended by adding three new sections to be appropriately designated and to read as follows:
53+ SECTION 2. Chapter 436E, Hawaii Revised Statutes, is amended by adding two new sections to be appropriately designated and to read as follows:
5454
5555 "§436E-A Requirements for initial licensure. (a) To qualify for licensure after July 1, 2023, an applicant shall submit evidence satisfactory to the board that the applicant meets the following educational and examination requirements:
5656
5757 (1) An individual applying for initial licensure shall have successfully completed an acupuncture medicine program from an accredited acupuncture medicine institution; provided that those applicants who graduated with an earned master's degree may apply to the board for the "L.Ac." license designation, and those applicants who graduated with an earned doctorate degree may apply to the board for the "D.Ac." license designation; and
5858
5959 (2) All applicants for initial licensure shall pass examinations and be certified by the National Certification Commission for Acupuncture and Oriental Medicine, or its successor entity.
6060
6161 (b) Applicants who have earned a bachelor's, master's, or doctoral degree from a foreign university or college shall demonstrate curricula and standards equivalent to or higher than accredited institutions in the United States, which have been recognized and approved by the board. The board may contract with a third-party agency to determine equivalency, at cost to the applicant.
6262
63- §436E-B Legacy exemptions. Any current acupuncture licensees in the State as of July 1, 2023, shall be designated legacy status by the board for their current license designation, allowing for the practice of acupuncture medicine. If a license that was issued before July 1, 2023, lapses and is not restored within two years of its expiration date, the licensee shall be subject to the licensure requirements pursuant to section 436E-A.
64-
65- §436E-C Reciprocity. (a) The board may issue a license by reciprocity to an acupuncturist if the applicant:
66-
67- (1) Files an application and pays fees as prescribed by the board;
68-
69- (2) Holds a current, unencumbered, active license in another state or territory that requires qualifications equivalent to or greater than the qualifications for licensure in the State as specified in section 436E-A; and
70-
71- (3) Holds a current certification with the National Certification Commission for Acupuncture and Oriental Medicine, or its successor entity.
72-
73- (b) For applicants who graduated before September 1, 2000, the board may issue a license by reciprocity to an acupuncturist if the applicant:
74-
75- (1) Files an application and pays fees as prescribed by the board;
76-
77- (2) Holds a current, unencumbered, active license in another state or territory; and
78-
79- (3) Holds a current certification with the National Certification Commission for Acupuncture and Oriental Medicine, or its successor entity."
63+ §436E-B Legacy exemptions. Any current acupuncture licensees in the State as of July 1, 2023, shall be designated legacy status by the board for their current license designation, allowing for the practice of acupuncture medicine. If a license that was issued before July 1, 2023, lapses and is not restored within two years of its expiration date, the licensee shall be subject to the licensure requirements pursuant to section 436E-A."
8064
8165 SECTION 3. Section 436E-1, Hawaii Revised Statutes, is amended to read as follows:
8266
8367 "[[]§436E-1[]] Declaration of necessity for regulation and control. The legislature hereby finds and declares that acupuncture medicine is an evidence-based medicine rooted in traditional and modern modalities and that the practice of acupuncture [is a theory and method for] medicine includes examination, evaluation, diagnosis, and treatment of [illness and disability and for strengthening and invigorating the body and as such affects] the patient, therefore requiring regulation and control for public health, safety, and welfare[, and therefore there is a necessity that individuals practicing acupuncture be subject to regulation and control]."
8468
8569 SECTION 4. Section 436E-2, Hawaii Revised Statutes, is amended as follows:
8670
8771 1. By adding seven new definitions to be appropriately inserted and to read:
8872
8973 ""Accredited acupuncture medicine institution" means a school or college accredited or recognized as a candidate for accreditation by an acupuncture medicine accrediting body recognized by the United States Department of Education.
9074
9175 "Acupuncture medicine" means the evidence-based medicine rooted in traditional theories and practices, integrated with modern biomedical theories and practices.
9276
9377 "Acupuncture medicine doctor" means an acupuncture practitioner engaged in the practice of advanced acupuncture medicine.
9478
95- "Licensed acupuncturist" means an acupuncture practitioner who has complied with all educational and professional examination requirements as determined by the board and whose license remains in good standing with the board, utilizing the license designation "L.Ac.".
79+ "Licensed acupuncturist" is an acupuncture practitioner who has complied with all educational and professional examination requirements as determined by the board and whose license remains in good standing with the board, utilizing the license designation "L.Ac.".
9680
97- "Licensed doctor of acupuncture" means an acupuncture medicine doctor who has complied with all educational and professional examination requirements as determined by the board and whose license remains in good standing with the board, utilizing the license designation "D.Ac.".
81+ "Licensed doctor of acupuncture" is an acupuncture medicine doctor who has complied with all educational and professional examination requirements as determined by the board and whose license remains in good standing with the board, utilizing the license designation "D.Ac.".
9882
9983 "Practice of acupuncture medicine" means the practice of acupuncture with adjunctive therapies, including but not limited to manual, mechanical, electrical, light, sound, electromagnetic, thermal therapy, herbal and nutraceutical medicines, lifestyle and nutritional counseling, movement, and other traditional and modern techniques as further determined by rules adopted by the board.
10084
101- "Practice of advanced acupuncture medicine" means the practice of acupuncture medicine and the use of advanced diagnostics, specialties, and therapeutics, as further determined by rules adopted by the board."
85+ "Practice of advanced acupuncture medicine" means the practice of acupuncture medicine and the use of advanced diagnostics, specialties, and therapeutics, based on additional traditional and biomedical internal medicine training, as further determined by rules adopted by the board."
10286
10387 2. By amending the definition of "acupuncture practitioner" to read:
10488
10589 ""Acupuncture practitioner" means a person engaged in the practice of acupuncture[.] medicine."
10690
10791 3. By amending the definition of "practice of acupuncture" to read:
10892
10993 ""Practice of acupuncture" means [stimulation of a certain acupuncture point or points on the human body for the purpose of controlling and regulating the flow and balance of energy in the body. The practice includes the techniques of piercing] the integrative examination, evaluation, diagnosis, prevention, and treatment of a physical, mental, or emotional disease in the patient by stimulating tissue by puncturing the skin [by inserting needles and point stimulation by the use of acupressure, electrical, mechanical, thermal, or traditional therapeutic means.] with a needle approved by the United States Food and Drug Administration to various depths or utilizing other means to achieve a response."
11094
11195 SECTION 5. Section 436E-3, Hawaii Revised Statutes, is amended to read as follows:
11296
113- "§436E-3 [License required.] Licensure. Except as otherwise provided by law, no person shall engage in the practice of acupuncture, practice of acupuncture medicine, or practice of advanced acupuncture medicine or use the title "acupuncturist" in [this] the State, either gratuitously or for pay, [or shall offer to so practice, or shall announce themselves either publicly or privately as prepared or qualified to so practice any method of acupuncture] without having [a valid unrevoked license or] an acupuncture medicine intern permit [from the State; provided that the requirement for a permit shall not be enforced until the board has initially adopted rules] pursuant to section 436E-3.6[.] or an "L.Ac." or "D.Ac." license designation from the board."
97+ "§436E-3 [License required.] Licensure. Except as otherwise provided by law, no person shall practice acupuncture or acupuncture medicine or use the title "acupuncturist" in this State, either gratuitously or for pay, [or shall offer to so practice, or shall announce themselves either publicly or privately as prepared or qualified to so practice any method of acupuncture] without having [a valid unrevoked license or] first obtained an acupuncture medicine intern permit [from the State; provided that the requirement for a permit shall not be enforced until the board has initially adopted rules] pursuant to section 436E-3.6[.] or an "L.Ac." or "D.Ac." license designation from the board."
11498
11599 SECTION 6. Section 436E-3.5, Hawaii Revised Statutes, is amended to read as follows:
116100
117- "§436E-3.5 Physicians and osteopaths not exempt. Persons licensed under chapter 453 who desire to engage in the practice of acupuncture, practice of acupuncture medicine, or practice of advanced acupuncture medicine shall be subject to licensing under this chapter."
101+ "§436E-3.5 Physicians and osteopaths not exempt. Persons licensed under chapter 453 who desire to practice acupuncture or acupuncture medicine shall be subject to licensing under this chapter."
118102
119103 SECTION 7. Section 436E-3.6, Hawaii Revised Statutes, is amended to read as follows:
120104
121- "[[]§436E-3.6[]] Acupuncture medicine intern permit required. [(a) Except as otherwise provided by law, no] No person shall engage in the practice [as an] of acupuncture, practice of acupuncture medicine, or practice of advanced acupuncture medicine as an intern in [this] the State, either gratuitously or for pay, [without having first obtained a permit from the board. This permit shall entitle the applicant to engage in the practice of acupuncture for a period of four years under the immediate supervision of a licensed acupuncturist duly licensed under this chapter.
105+ "[[]§436E-3.6[]] Acupuncture medicine intern permit required. [(a) Except as otherwise provided by law, no] No person shall practice [as an] acupuncture or acupuncture medicine as an intern in this State, either gratuitously or for pay, [without having first obtained a permit from the board. This permit shall entitle the applicant to engage in the practice of acupuncture for a period of four years under the immediate supervision of a licensed acupuncturist duly licensed under this chapter.
122106
123107 (b) An acupuncture intern permit may be reissued once, for a period not to exceed one year, upon written request to the board and payment of the required fee.
124108
125109 (c) The board shall adopt rules pursuant to chapter 91 defining the functions of an acupuncture intern, establishing the requirements to be met by an applicant for an acupuncture intern permit, and specifying the procedures for the immediate supervision of the acupuncture intern by a licensed acupuncturist.] unless the intern:
126110
127111 (1) Is actively enrolled in a program with an accredited acupuncture medicine institution;
128112
129113 (2) Has obtained a permit from the board, which shall be valid for four years and may be renewed once for a period not to exceed one year; and
130114
131115 (3) Is practicing under the immediate supervision of an acupuncture practitioner or acupuncture medicine doctor who is licensed in the State and contracted or employed through an accredited acupuncture medicine institution."
132116
133117 SECTION 8. Section 436E-6, Hawaii Revised Statutes, is amended to read as follows:
134118
135119 "§436E-6 Board of acupuncture. (a) There shall be a board of acupuncture, the members of which shall be appointed by the governor.
136120
137121 The board shall consist of five persons, two of whom shall be private citizens and three shall be [acupuncturists licensed in accordance with this chapter.] licensed acupuncturists or licensed doctors of acupuncture.
138122
139- (b) [Commencing July 1, 1992, and thereafter, each] Each person appointed to the board shall have a four-year term and shall serve [not] no more than two consecutive terms. [Members appointed to the board prior to July 1, 1992, shall be permitted to continue to serve on the board until such time when a maximum of eight consecutive years from the date of initial appointment has been attained.]"
123+ (b) [Commencing July 1, 1992, and thereafter, each] Each person appointed to the board shall have a four-year term and shall serve not more than two consecutive terms. [Members appointed to the board prior to July 1, 1992, shall be permitted to continue to serve on the board until such time when a maximum of eight consecutive years from the date of initial appointment has been attained.]"
140124
141125 SECTION 9. Section 436E-7, Hawaii Revised Statutes, is amended to read as follows:
142126
143127 "§436E-7 Powers and duties of the board. In addition to any other powers and duties authorized by law, the board shall:
144128
145129 (1) Adopt rules in accordance with chapter 91 to carry out the purposes of this chapter, with special emphasis on the health and safety of the public;
146130
147131 (2) [Develop] Define and clarify ongoing standards for licensure;
148132
149133 (3) Define and clarify standards and practices for license renewal, including continuing education requirements;
150134
151135 [(3)] (4) Prepare, administer, and grade examinations, provided that the board may contract with a testing agency to provide those services;
152136
153137 [(4)] (5) Issue, renew, suspend, and revoke licenses;
154138
155139 [(5)] (6) Register applicants or holders of a license;
156140
157141 [(6)] (7) Investigate and conduct hearings regarding any violation of this chapter and any rules of the board;
158142
159143 [(7)] (8) Maintain a record of its proceedings; [and]
160144
161- (9) Define and clarify reciprocity for persons licensed in other jurisdictions visiting the State for purposes of education and instruction, within a limited scope of time;
145+ (9) Define and clarify reciprocity for acupuncture licensees from other jurisdictions visiting the State for purposes of education and instruction, within a limited scope of time;
162146
163- (10) Define and clarify standards for reciprocity for persons licensed in other jurisdictions who have:
147+ (10) Define and clarify standards for reciprocity for licensees from other jurisdictions who have:
164148
165149 (A) Completed their education prior to the year 2000;
166150
167151 (B) Maintained their license; and
168152
169153 (C) Maintained their certification with the National Certification Commission for Acupuncture and Oriental Medicine; and
170154
171155 [(8)] (11) Do all things necessary to carry out the functions, powers, and duties set forth in the chapter."
172156
173157 SECTION 10. Section 436E-9, Hawaii Revised Statutes, is amended to read as follows:
174158
175159 "[[]§436E-9[]] Biennial renewal[.]; continuing education. (a) Every person holding a license under this chapter shall register with the board and pay a biennial fee on or before June 30 of each odd-numbered year. Failure to pay the biennial fee shall constitute a forfeiture of the license as of the date of expiration. Any license so forfeited may be restored within [one year] two years after the expiration upon filing of an application and payment of a restoration fee.
176160
177- (b) Beginning with the renewal for the licensing biennium commencing July 1, 2025, and every biennial renewal thereafter, all licensees in the State shall be in compliance with continuing education requirements, as approved by the board, by obtaining at least thirty credit hours, which shall include at least two credit hours of ethics and at least two credit hours of safety. The board shall adopt rules pursuant to chapter 91 relating to the requirements and standards that continuing education programs shall meet to obtain recognition and approval from the board.
178-
179- (c) To determine compliance with the continuing education requirement under subsection (b), the board may conduct a random audit of licensees. A licensee selected for audit shall be notified by the board. Within sixty days of notification, the licensee shall provide the board documentation to verify compliance with the continuing education requirements.
180-
181- (d) Licensees shall hold a current and valid cardiopulmonary resuscitation certification."
161+ (b) Beginning with the renewal for the licensing biennium commencing July 1, 2023, and every biennial renewal thereafter, all licensees in the State shall be in compliance with continuing acupuncture medicine education requirements, as approved by the board, by obtaining at least thirty credit hours of continuing education, which shall include at least two credit hours of ethics and at least two credit hours of safety. Licensees shall hold a current and valid cardiopulmonary resuscitation certification as a condition of license renewal."
182162
183163 SECTION 11. Section 436E-10, Hawaii Revised Statutes, is amended to read as follows:
184164
185- "§436E-10 Revocation or suspension of licenses[.]; penalties. (a) In addition to any other actions authorized by law, any license to engage in the practice of acupuncture, practice of acupuncture medicine, or practice of advanced acupuncture medicine under this chapter may be revoked or suspended by the board of acupuncture at any time in a proceeding before the board for any cause authorized by law, including but not limited to the following:
165+ "§436E-10 Revocation or suspension of licenses[.]; penalties. (a) In addition to any other actions authorized by law, any license to practice acupuncture or acupuncture medicine under this chapter may be revoked or suspended by the board of acupuncture at any time in a proceeding before the board for any cause authorized by law, including but not limited to the following:
186166
187167 (1) Obtaining a fee on the assurance that a manifestly incurable ailment can be permanently cured;
188168
189169 (2) The use of false, fraudulent, or deceptive advertising and making untruthful and improbable statements;
190170
191171 (3) [Habitually using] Using any [habit-forming] intoxicant or controlled substance[, such as opium or any of its derivatives, morphine, heroin, or cocaine;] that impairs or compromises a licensee's duties, as determined by rules;
192172
193173 (4) Procuring a license through fraud, misrepresentation, or deceit;
194174
195175 (5) Professional misconduct [or], gross carelessness, ethics violations, or manifest incapacity [in the practice of acupuncture;], as determined by rules; or
196176
197177 (6) Violating any rules adopted under this chapter.
198178
199- (b) Any person except a person licensed under this chapter who practices, treats, or instructs in any phase of acupuncture or acupuncture medicine without a license or permit issued by the board, or uses any word or title to induce the belief that the person is engaged in the practice of any type of acupuncture or acupuncture medicine, shall be guilty of a misdemeanor and subject to a fine of no less than $1,000 for each day of violation. The department may also seek all legal and equitable remedies available to it for the enforcement of the provisions of this chapter, including injunctive relief."
179+ (b) Any person except a person licensed under this chapter who practices, treats, or instructs in any phase of acupuncture or acupuncture medicine without a license or permit issued by the board, or uses any word or title to induce the belief that the person is engaged in the practice of any type of acupuncture or acupuncture medicine, shall be guilty of a misdemeanor and subject to a fine of not less than $1,000 for each day of violation. The department may also seek all legal and equitable remedies available to it for the enforcement of the provisions of this chapter, including injunctive relief."
200180
201181 SECTION 12. Section 436E-4, Hawaii Revised Statutes, is repealed.
202182
203183 ["§436E-4 Exemptions. A licensed acupuncturist of another state or country for demonstrations or lectures to be given at acupuncture or medical society meetings or at acupuncture schools shall be exempt from licensing procedures set forth in this chapter."]
204184
205185 SECTION 13. Section 436E-5, Hawaii Revised Statutes, is repealed.
206186
207187 ["§436E-5 Qualifications for examination. (a) No person shall be licensed to practice acupuncture unless the person has passed an examination and has been found to have the necessary qualifications as prescribed in the rules adopted by the board pursuant to chapter 91.
208188
209189 (b) Prior to September 1, 2000, and except as provided in subsection (c), before any applicant shall be eligible for the examination, the applicant shall furnish satisfactory proof to the board that the applicant has received a total of not less than one thousand five hundred hours of education and training consisting of:
210190
211191 (1) A formal program in the science of acupuncture (traditional oriental medicine) at an institute or school approved by the board that:
212192
213193 (A) Shall be for a period of not less than two academic years (not less than six hundred hours); and
214194
215195 (B) Shall result in the award of a certificate or diploma; and
216196
217197 (2) One clinical year in a clinical internship program (not less than twelve months and not less than nine hundred hours) supervised by a licensed acupuncturist; provided that the nine hundred hours of the clinical internship program may be obtained from the institute or school awarding the certificate or diploma or may be obtained under the supervision of a licensed acupuncturist not affiliated with an institute or school.
218198
219199 (c) Students who started training prior to December 31, 1984, in a school approved by the board prior to December 31, 1984, and who complete their training by December 31, 1989, and who file an application with the board before September 1, 2000 shall:
220200
221201 (1) Not lose their rights of continued education, and earned or accumulated credits; and
222202
223203 (2) For the purposes of this chapter, meet requirements for examination and licensure as provided in chapter 436D and rules adopted by the board as they existed on December 31, 1984; provided that the school has not altered its program so as to lower the standards for completion of the program. These students may qualify for examination if they submit evidence of having completed:
224204
225205 (A) At least eighteen months (not less than five hundred seventy-six hours) of academic training; and
226206
227207 (B) At least six months (not less than four hundred eighty hours) of clinical training in the practice of acupuncture on human subjects under the supervision of a licensed acupuncturist.
228208
229209 (d) Notwithstanding subsections (b) and (c), effective September 1, 2000, before any applicant shall be eligible to take the licensing examination, the applicant shall furnish satisfactory proof to the board that the applicant has completed a formal acupuncture program and has received a total of at least two thousand, one hundred seventy-five hours of academic and clinical training consisting of an academic program of at least one thousand, five hundred fifteen hours in the science of acupuncture (traditional oriental medicine) and a clinical training program of at least six hundred sixty hours under the supervision of a licensed acupuncturist, which shall result in the award of a certificate or diploma. For applicants who graduated from an institute, school, or college located in the United States or any territory under the jurisdiction of the United States, the institute, school, or college shall be accredited or recognized as a candidate for accreditation by any acupuncture or oriental medicine accrediting body recognized by the United States Department of Education. For applicants who graduated from a foreign institute, school, or college with a formal program in the science of acupuncture, the applicant, at the applicant's own expense, shall have the applicant's transcripts and curriculum evaluated by a board approved and designated professional evaluator who shall make a determination whether the transcripts and curriculum are at least equivalent to that of the United States accredited acupuncture program, and that the foreign institute is licensed, approved, or accredited by the appropriate governmental authority or an agency recognized by a governmental authority in the respective foreign jurisdiction and whose curriculum is approved by the board."]
230210
231211 SECTION 14. Section 436E-12, Hawaii Revised Statutes, is repealed.
232212
233213 ["[§436E-12] Penalty. (a) Any person except a person licensed under this chapter who practices, treats, or instructs in any phase of acupuncture without a license or permit issued by the board, or uses any word or title to induce the belief that they are engaged in the practice of any type of acupuncture, shall be guilty of a misdemeanor and subject to a fine of not less than $50 nor more than $1,000 for each violation.
234214
235215 (b) Any person, except a licensed acupuncturist, who:
236216
237217 (1) Practices or attempts to practice acupuncture;
238218
239219 (2) Buys, sells, or fraudulently obtains any diploma or license to practice acupuncture whether recorded or not;
240220
241221 (3) Uses the title "acupuncturist", "D.Ac." or "D.O.M." or any word or title to induce the belief that the person is engaged in the practice of acupuncture without complying with this chapter; or
242222
243223 (4) Violates this chapter;
244224
245225 shall be penalized as provided in subsection (a). The department may also seek all legal and equitable remedies available to it for the enforcement of the provisions of this chapter, including seeking injunctive relief."]
246226
247227 SECTION 15. Section 436E-13, Hawaii Revised Statutes, is repealed.
248228
249229 ["§436E-13 Use of titles. (a) A licensee who has been awarded a license to practice acupuncture by the board in this State may use the title of "Licensed Acupuncturist" or designation "L.Ac." with the licensee's name in an advertisement for acupuncture or announce or append the designation to the licensee's name.
250230
251231 (b) A licensee who has been awarded an earned doctoral degree may use the designation "Ph.D." in an advertisement for acupuncture or announce or append the designation to the licensee's name if the degree was granted from a university or college recognized by a regional or national accrediting body recognized by the United States Department of Education. A Ph.D. recognized by the board under this subsection shall designate a nonpractitioner as opposed to a practitioner or "doctor" of acupuncture as provided in subsection (c).
252232
253233 (c) A licensee who has been approved by the board to use the doctor of acupuncture title, may use the title "Doctor of Acupuncture" or designation of "D.Ac.", after the licensee's name, or the term "Doctor" or prefix "Dr." provided that the word "Acupuncturist" immediately follows the licensee's name if the term "Doctor", or the prefix "Dr." is used alone.
254234
255235 (d) Before any licensee shall be eligible to use the doctor of acupuncture title, the licensee shall furnish satisfactory proof to the board that the licensee has been awarded an earned doctoral degree in acupuncture (traditional oriental medicine). For licensees who graduated from an institute, school, or college located in the United States or any territory under the jurisdiction of the United States, the institute, school, or college shall be accredited or recognized as a candidate for accreditation by a regional or national accrediting body that is recognized by the United States Department of Education for the accreditation or pre‑accreditation ("candidacy") of professional post-graduate doctoral programs in acupuncture and oriental medicine. For licensees who graduated from a foreign institute, school, or college, the licensee, at the licensee's own expense, shall have the licensee's transcripts and curriculum evaluated by a board approved and designated professional evaluator who shall make a determination on whether the transcripts and curriculum are at least equivalent to the United States recognized doctoral program of study in acupuncture and oriental medicine, and that the foreign institute is licensed, approved, or accredited by the appropriate governmental authority or an agency recognized by a governmental authority in the respective foreign jurisdiction and whose curriculum is approved by the board.
256236
257237 (e) Except as provided in this section, use of other titles, prefixes, or designations shall not be permitted."]
258238
259239 SECTION 16. Section 436E-14, Hawaii Revised Statutes, is repealed.
260240
261241 ["[§436E-14] Foreign school curricula and standards. The board of acupuncture shall not recognize and approve an earned doctoral degree from a foreign university or college whose curricula and standards are not equivalent to or higher than institutions in the United States which have been recognized and approved by the board in the study or practice of acupuncture."]
262242
263- SECTION 17. In codifying the new sections added by section 2 of this Act, the revisor of statutes shall substitute appropriate section numbers for the letters used in designating the new sections in this Act.
243+ SECTION 17. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
264244
265- SECTION 18. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
266-
267- SECTION 19. This Act shall take effect on July 1, 2060.
245+ SECTION 18. This Act shall take effect on July 1, 2060.
268246
269247
270248
271- Report Title: Acupuncture; Licensure; Continuing Education; Acupuncture Medicine; Acupuncture Medicine Doctors Description: Makes comprehensive updates to chapter 436E, Hawaii Revised Statutes, regarding acupuncture practitioners to reflect modernized scopes of practice, titles, and licensing and renewal requirements, including thirty hours of continuing education per licensing biennium. Effective 7/1/2060. (HD2) The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.
249+ Report Title: Acupuncture; Licensure; Continuing Education; Acupuncture Medicine; Acupuncture Doctors Description: Makes comprehensive updates to chapter 436E, Hawaii Revised Statutes, regarding acupuncture practitioners to reflect modernized scopes of practice, titles, and licensing and renewal requirements, including thirty hours of continuing education per licensing biennium. Effective 7/1/2060. (HD1) The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.
272250
273251
274252
275253 Report Title:
276254
277-Acupuncture; Licensure; Continuing Education; Acupuncture Medicine; Acupuncture Medicine Doctors
255+Acupuncture; Licensure; Continuing Education; Acupuncture Medicine; Acupuncture Doctors
278256
279257
280258
281259 Description:
282260
283-Makes comprehensive updates to chapter 436E, Hawaii Revised Statutes, regarding acupuncture practitioners to reflect modernized scopes of practice, titles, and licensing and renewal requirements, including thirty hours of continuing education per licensing biennium. Effective 7/1/2060. (HD2)
261+Makes comprehensive updates to chapter 436E, Hawaii Revised Statutes, regarding acupuncture practitioners to reflect modernized scopes of practice, titles, and licensing and renewal requirements, including thirty hours of continuing education per licensing biennium. Effective 7/1/2060. (HD1)
284262
285263
286264
287265
288266
289267
290268
291269 The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.